Need: Research suggests that physical activity improves the health, physical functioning, and quality of life of cancer survivors. Cohort studies also show links between physical activity after breast, prostate, or colorectal cancer diagnosis to a lower risk of recurrence and death from cancer. Despite this evidence and physical activity recommendations for survivors from national organizations, the majority of cancer survivors do not adhere to these recommendations. Cancer survivors who are minority or low-income may be particularly at risk for being physically inactive. Currently there are few programs to help Texas’ 775,000 cancer survivors become more physically active. In particular, th...

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Need: Research suggests that physical activity improves the health, physical functioning, and quality of life of cancer survivors. Cohort studies also show links between physical activity after breast, prostate, or colorectal cancer diagnosis to a lower risk of recurrence and death from cancer. Despite this evidence and physical activity recommendations for survivors from national organizations, the majority of cancer survivors do not adhere to these recommendations. Cancer survivors who are minority or low-income may be particularly at risk for being physically inactive. Currently there are few programs to help Texas’ 775,000 cancer survivors become more physically active. In particular, there is a need for low-cost or free programs with innovative deliver models that are accessible to minority, low-income, medically underserved, or rural cancer survivors. Overall Project Strategy: We propose to expand our current Active Living after Cancer (ALAC) program to cover counties that are medically underserved and/or rural. The program currently is provided through implementation partners in Houston and El Paso. Under this expansion grant we will add partners in Beaumont and Tyler to extend the program to survivors in East Texas, Department of State Health Services Regions 6/5S and 4/5N. The goal of ALAC is to improve the physical functioning and quality of life of sedentary cancer survivors, particularly those who are minority, medically underserved, or living in rural/medically underserved areas. The 12-session program teaches behavioral and cognitive skills to help cancer survivors increase their physical activity by incorporating moderate intensity physical activity into daily life. The program also provides support related to health and quality of life issues important to cancer survivors, including fatigue, psychological distress, nutrition, and communication with health care providers, and will navigate participants to appropriate services. The University of Texas MD Anderson Cancer Center will serve as the training and evaluation center for this program, and will partner with four organizations, Kelsey Research Foundation (Houston), Cancer and Chronic Disease Consortium (El Paso), Gift of Life (Beaumont), and University of Texas Health Science Center - Tyler, that will promote and implement the program. These partners will be trained to administer the program independently using telementoring sessions based on the Project ECHO model. Specific Goals: (1) Provide the ALAC program to 1,350 cancer survivors in Houston, El Paso, Tyler, and Beaumont and nearby counties with a focus on minority, medically underserved and rural populations; (2) Develop relationships with referral partners for the ALAC Program (3 new referral partners in year 1, 2/year in years 2 and 3), including health care organizations, churches, and community organizations with contact with cancer survivors, particularly organizations in underserved communities; (3) Increase physical activity and improve physical functioning and quality of life among cancer survivors participating in the ALAC group program. Innovation: This program uses an innovative approach toward increasing physical activity. Rather than promote structured exercise at a gym several times a week, this program recommends increasing physical activity by incorporating short bouts of moderate intensity activity into daily life. Research shows this approach improves fitness and health outcomes, and overcomes barriers that make it difficult to sustain physical activity. The program also combines the physical activity program with support and navigation services to help cancer survivors cope with salient cancer-related issues. The program will use Project ECHO’s model of telementoring to train implementation partners. This model is a novel approach to build a referral network and train community partners to independently implement the program successfully. The program will increase cancer survivorship resources and physical activity programs to improve the wellness and quality of life of cancer survivors in the Houston and El Paso areas. Significance and Impact: By helping cancer survivors become more physically active, physical functioning and quality of life will be significantly improved, which can result in being better able to resume pre-diagnosis roles and activities, such as paid employment, caring for family members, and enjoying leisure time activities. An increase in physical activity may also help increase cancer survival, and reduce the risk of recurrence and death from cancer. The telementoring model is an innovative, proven approach that supports each community partner’s independent implementation of the program and creates an open network to identify and manage other needs for cancer survivors statewide.

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